During the European Society of Hypertension (ESH) 2023 scientific meeting in Milan, a joint session from the ISH, ESH and the French Society of Hypertension (SFHTA) explored the management of common, uncommon and very rare side effects of antihypertensive treatment.

The session panel was chaired by ISH President Bryan Williams (London, UK), ESH President Guido Grassi (Milan, Italy), and SFHTA President Beatrice Duly Bouhanick (Toulouse, France). 

The session commenced with remarks from Professor Atul Pathak from Monaco, who serves on the ESH council and is the Immediate Past President of the SFHTA. In his opening address, he expressed appreciation for the joint session – a collaborative endeavour among the societies – and underlined the crucial importance of managing the adverse effects of antihypertensive treatments appropriately. 

One of the distinguished speakers was Professor Michel Burnier from Lausanne (Switzerland) who spoke on the risks and management strategies associated with hypo and hyperkalemia. Subsequently, Dr Eugenia Gkaliagkousi, Associate Professor in Internal Medicine at Aristotle University of Thessaloniki, shared a practical approach to handling hyponatremia, particularly when associated with diuretics. 

Dr Sébastien Rubin, Nephrologist in Bordeaux (France) and a fellow from the University of Manchester (UK) steered the conversation towards the mechanisms causing elevated creatinine levels, particularly with the use of Renin-Angiotensin System Inhibitors (RASi). He emphasized the importance of maintaining these treatments in most situations. 

Lastly, Professor Maciej Tomaszewski from the University of Manchester (UK), and Immediate Past President of the ISH, presented a thorough description of neurotic angioedema linked to ACE inhibitors. He gave a nuanced explanation about the need to avoid reintroducing these drugs in case of a cough, and instead consider Angiotensin Receptor Blockers (ARBs). He closed by reporting the risk of anemia associated with antihypertensive drugs. 

All in all, the session was a worthwhile exchange of knowledge and expertise that left attendees appreciating the depth and breadth of the discussions.